补阳还五汤联合双抗血小板聚集治疗缺血性脑卒中患者的临床疗效及对血清炎性因子的影响

Effect of Buyanghuanwu Decoction Combined with Dual Antiplatelet Therapy on Ischemic Stroke and Serum Inflammatory Factors

目的探讨补阳还五汤联合双抗血小板聚集治疗缺血性脑卒中患者的临床疗效及对血清炎性因子的影响。方法选取2019年1月—2020年12月期间于唐山市中医医院脑病科、老年病科住院的82例缺血性脑卒中患者作为研究对象,根据患者就诊顺序采用随机数字表法将患者分为对照组和治疗组,每组各41例。两组患者均予控制血压、营养支持等常规治疗措施,对照组予双抗血小板聚集(具体药物为阿司匹林肠溶片联合氯吡格雷),治疗组在对照组的基础上予补阳还五汤,两组患者均治疗3周。观察并比较两组患者临床疗效,治疗前后神经功能缺损评分、中医症状评分、炎性因子(肿瘤坏死因子(Tumor necrosis factor-α,TNF-α)、白细胞介素-1(Interleukin-1,IL-1)、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-8(Interleukin-8,IL-8)炎性因子水平)水平变化及不良反应情况。结果(1)治疗后治疗组总有效率为85.37%(35/41),高于对照组58.53%(24/41),差异有统计学意义(P<0.05)。(2)治疗后两组患者神经功能缺损评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组神经功能缺损评分较对照组降低,差异有统计学意义(P<0.05)。(3)治疗后两组患者中医症状评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组中医症状评分较对照组降低,差异有统计学意义(P<0.05)。(4)治疗后两组患者TNF-α、IL-1、IL-6、IL-8水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组TNF-α、IL-1、IL-6、IL-8水平较对照组降低,差异有统计学意义(P<0.05)。(5)在治疗期间,两组患者均未出现明显不良反应。结论补阳还五汤联合双抗血小板聚集能有效改善患者临床症状,缓解神经缺陷程度,降低炎性因子水平,提高临床疗效。

Objective To explore the effect of Buyanghuanwu Decoction combined with dual antiplatelet therapy(DAT)on ischemic stroke and serum inflammatory factors.Methods From January 2019 to December 2020,82 patients with ischemic stroke who were hospitalized in Department of Encephalopathy and Department of Geriatrics of Tangshan Hospital of Traditional Chinese Medicine were selected.According to the order of treatment,they were randomized into the control group and treatment group with the random number table method,with 41 in either group.Both groups received routine treatment such as blood pressure control and nutritional support.On this basis,DAT(Aspirin Enteric-coated Tablets+clopidogrel)was added in the control group,and Buyanghuanwu Decoction and DAT were added in the treatment group.The treatment lasted 3 weeks for both groups.The clinical efficacy,neurological functionaldeficit score(NIHSS score),traditional Chinese medicine(TCM)syndrome score,and inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),interleukin-6(IL-6),and interleukin-8(IL-8)]were determined before and after treatment in thetwo groups,and the adverse reactions were observed.Results(1)The total effective rate in treatment group was 85.37%(35/41),as compared with the 58.53%(24/41)in control group(P<0.05).(2)After treatment,the NIHSS scorewas lower than that before treatment in both groups(P<0.05),and lower in the treatment group than in the control group(P<0.05).(3)After treatment,TCM syndrome score was lower than that before treatment in both groups(P<0.05)and lower in the treatment group than in the control group(P<0.05).(4)After treatment,the levels of TNF-α,IL-1,IL-6,and IL-8 in the two groups were decreased compared with those before treatment(P<0.05)and the levels in thetreatment group were lower than those in the control group(P<0.05).(5)During the treatment,no obvious adverse reactions occurred in either group.Conclusion Buyang Huanwu Decoction combined with DAT can effectively improve the clinical symptoms of patients,relieve neurological functionaldeficit,and reduce the levels of inflammatory factors,thus enhancing the clinical efficacy.